JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Risk factors and a predictive nomogram for regional lymph node metastasis in deficient mismatch repair colorectal cancer

  • 0Department of General Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Frontiers in Oncology +

|

July 4, 2025

|

July 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

This study identifies key risk factors for lymph node metastasis in deficient mismatch repair (dMMR) colorectal cancer (CRC). A predictive nomogram was developed to aid in early clinical decision-making for dMMR CRC patients.

Area Of Science

  • Oncology
  • Gastroenterology
  • Pathology

Background

  • Deficient mismatch repair (dMMR) or microsatellite instability (MSI) is a distinct molecular subtype of colorectal cancer (CRC).
  • Regional lymph node metastasis (LNM) is a critical prognostic factor in CRC, influencing treatment strategies and patient outcomes.
  • Accurate preoperative prediction of LNM in dMMR CRC is essential for personalized treatment planning.

Purpose Of The Study

  • To identify independent risk factors for regional LNM in patients with dMMR/MSI CRC.
  • To develop and validate a predictive nomogram for preoperative assessment of LNM in this patient cohort.
  • To improve the preoperative prediction of LNM for dMMR CRC, aiding in individualized treatment strategies.

Main Methods

  • Retrospective analysis of clinicopathological data from 131 patients with Stage I-III dMMR/MSI CRC.
  • Univariate and multivariate logistic regression analyses to determine independent risk factors for LNM.
  • Development and internal validation of a clinicopathological nomogram, including decision curve analysis.

Main Results

  • Age, tumor location, degree of differentiation, depth of invasion, and specific MMR protein immunohistochemistry results were identified as independent risk factors for LNM.
  • The developed nomogram demonstrated good discriminability and calibration for predicting LNM.
  • Decision curve analysis supported the clinical utility of the nomogram for early prediction of regional LNM.

Conclusions

  • A validated clinicopathological nomogram effectively predicts regional LNM in dMMR/MSI CRC patients.
  • The nomogram facilitates preoperative risk stratification, enabling tailored treatment approaches and potentially improving patient prognoses.
  • Further external validation of the nomogram is recommended to confirm its generalizability.

Keywords: